Fine wrinkles around the lips and. eyes can be treated well with the above mentioned modalities, but what about the deeper lines? In the upper half of the face, the horizontal expression lines of the forehead, vertical lines between the eyebrows {glabellar lines) and at the lateral extension of the eyes (crow's feet) are the most apparent signs of aging. These lines are generally due to dynamic muscle action and hence the treatment should be geared toward paralysing the muscle which causes them. This may sound extreme, but can be done quite elegantly and safely with Botox. This is a short term for Botulinum toxin ( I dont like the word toxin either!) which was intially used for paralysing muscles causing unwanted movements like uncontrolled blinking of the eyes (blepharospasm) or of the neck ( torticollis), it was noticed while using it around the eyes that it decreased or indeed completely obliterated all the wrinkles in the area. The results are dramatic. Within a week the Hues are completely gone in most cases, with some needing a "top up" after a week. The latter cases are usually due to the fact that the treating physician has missed the target muscle initially. It may also be due to the individual variance of muscle strength, some people needing a higher dose of toxin than others. Botox has found great acceptance in the US, with Los Angeles plastic surgeons, for instance performing more than 200 injections per week. The results are unfortunately not permanent, with the muscle action returning in three to five monts on a average. However after each treatment the results last a little longer with patients ultimately needing two treatments per year. Serious side effectsfrom treatment are uncommon. Small areas of bruising may be present after the injections, and if the toxin diffuses farther away from the target than expected, it may cause temporary weakness of other muscles. This can lead to drooping of the eyelid or assymetrical facial expression in rare cases. These problems resolve in a few weeks.
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